Last week, an editorial in the National Post by Tim Caulfield ruffled a few homeopathic feathers. In it, Caulfield argues that when provinces grant regulatory status to alternative practitioners like naturopathy, they are legitimizing rank quackery. This is the case because naturopathy relies heavily on homeopathy, which Caulfield correctly describes as “bogus”.

Canadian supporters of homeopathy are feeling the heat. Karen Wehrstein, homeopath and Executive Director of the Canadian Consumers Centre for Homeopathy responded to Caulfield’s criticism, defending homeopathy as a legitimate practice. The result is underwhelming, relying largely on appeals to its apparent popularity, and simple insistence that the science is actually coming in in favour of the homeopathic approach.

Even so, her claims require scrutiny. She begins her defense of homeopathy by describing how popular it is:

Homeopathy is so well trusted that 300 million patients in more than 80 nations use it. In countries such as the U.K., Brazil, parts of India, Mexico and Cuba, homeopathy is integrated into the health system and covered by public health insurance. In Europe, three out of four people are familiar with it. In Cuba, mass dosing of preventive homeopathic medicines is now used routinely by the public health system for epidemic control. One of the world’s most popular over-the-counter flu medicines — Oscillococcinum — is a homeopathic remedy … Homeopathy is now a regulated health profession in Ontario, and homeopathic medicines are classified by Health Canada.

Wehrstein provides no reference to back up her claim that over 300 million people use homeopathy worldwide. Other proponents claim a much lower number. Even if her number is accurate, simple use does not imply efficacy, which she well knows. Further, use does not equate to trust (belief in efficacy). Some people may be genuinely unaware of what they are using, some people may confuse homeopathy with herbal remedies, and some people may not have access to real medicine.

What about all these countries that integrate homeopathy into their publicly funded healthcare systems? Indeed, you would think that if the evidence was that impressive for homeopathy, more than a small handful of countries would endorse it. Instead, what you see is critical rejection of homeopathy. Wehrstein specifically mentions the UK as an example of a country that endorses and pays for homeopathy as part of its national health plan. This is misleading. In 2009, the UK’s parliamentary Science and Technology Committee specifically reviewed the scientific evidence that supported government policy and found the following.

The Government’s position on homeopathy is confused. On the one hand, it accepts that homeopathy is a placebo treatment. This is an evidence-based view. On the other hand, it funds homeopathy on the NHS without taking a view on the ethics of providing placebo treatments. We argue that this undermines the relationship between NHS doctors and their patients, reduces real patient choice and puts patients’ health at risk. The Government should stop allowing the funding of homeopathy on the NHS. We conclude that placebos should not be routinely prescribed on the NHS. The funding of homeopathic hospitals—hospitals that specialise in the administration of placebos—should not continue, and NHS doctors should not refer patients to homeopaths.

The UK doesn’t endorse homeopathy as effective and it does not fund homeopathy because it’s effective. Proponents in the UK had every opportunity to present the best scientific evidence it had to support homeopathic principles and products. They failed. Similarly should a similar inquiry ever be conducted in Canada to examine the evidence in support of the regulation of naturopaths, homeopaths and homeopathic remedies, ruling governments would be in a position to have to explain why they directly and indirectly legitimize witch doctors and magical potions as medicine. I long for the day. Ironically, part of Caulfield’s argument is that by regulating this nonsense, these problematic practices are legitimized. How does Ms. Wehrstein defend the legitimacy of homeopathy? By citing government regulation. Point to Caulfield.

A massive study showing that homeopathy is more cost-effective than any other forms of medicine, traditional or alternative, was commissioned by the government of Switzerland and published in 2011.

There are, in fact, many promising studies on homeopathy, across a broad number of fields. Of the meta-analyses — studies measuring the number and results of existing studies — that have been published, the majority show findings promising enough to recommend further research in the field.

It is routine for homeopaths to assert that there is good evidence that homeopathy works and more is coming in every day, but this is a weaker assertion by Wehrstein. Really? Of all the published studies the best homeopathy can do is show promise? This is hardly good enough if it were true, but it turns out that it is not.

Homeopaths in the UK attempted to convince the Science and Technology Committee much the same thing the Wehrstein is trying to convince us of here – that most of the available meta analyses show that homeopathy is effective. However, it turns out that of the 5 cited by British homeopaths (and I think it’s fair to assume that Wehrstein includes these in her majority), 2 were outdated, 1 was a republication of one of the outdated reviews that was actually less than positive, 1 though initially positive was re-analysed 6 separate times with negative results and the last was completely negative. In other words, the reviews do not show that homeopathy works, nor do they show that homeopathy is somehow “promising”. For more information, see page 18 of the Committee report.

The largest single study of homeopathy ever published was conducted under the auspices of the Cuban Ministry of Health in 2007. The populations of the three provinces of Cuba most threatened by the hurricane-triggered disease leptospirosis — a total of 2.3 million people — were all given two doses of a preventative homeopathic medicine in advance of the time of worst danger. The result: “The homeoprophylactic approach was associated with a large reduction of disease incidence and control of the epidemic.”

Wehrstein fails to mention why this study is rejected as evidence for homeopathy’s efficacy yet presents it as if its definitive. It isn’t. The provinces that were treated with the homeopathic vaccine were experiencing a spike in infection prior to the intervention. With no control for this, the authors cannot conclude that homeopathy caused a decline in infection. In fact, randomization within the treatment area was possible, but somehow not thought of by the homeopaths running the study. For me the real nail in the coffin for this paper is the fact that despite such success in getting 96% of the treatment region covered, rates of infection were subsequently no better than in 2004, without homeopathy. In other words, homeopathy probably didn’t work. For an excellent takedown and discussion of other irregularities and curiosities in this study, please click here.

There is no magic or witchcraft in homeopathy. Anyone of any (or no) religious or spiritual tradition can practise it with training, and the patient does not have to believe in it for it to work (else it wouldn’t affect infants, animals and microbes). In homeopathy, positive results require the use of standard and repeatable procedures based on consistent principles, which are the core of the curricula of homeopathic colleges.

It’s also true that anyone can practice reading goat entrails to play the stock market with a little training (and for a fee) at any reputable Entrail Reading College. Can you imagine the visceral chaos if the curricula were not standardized?

More seriously, standardized, repeatable procedures and consistent principles are great and desirable, but unless the principles have objective and demonstrable merit, everything you do based on them is empty, meaningless ritual. A little like making a magic potion.

Homeopathy’s big stumbling block to acceptance is that its medicines are diluted so much that people outside of the field can’t understand how they can possibly have an effect. There are, however many scientists who do have that expertise. So many, that there is an entire journal devoted to the field, the International Journal of High Dilution Research. And they seem to be getting intriguingly close to providing definitive answers.

It’s typical for homeopaths to claim that skeptics are not able to understand how homeopathy works because they’re not experts in homeopathy. However, skeptics understand just how dilute most remedies on the market are and it requires no real expertise to understand that homeopathy cannot work. Even the most scientifically illiterate person (who isn’t a homeopath) is likely to call BS when they hear that the smaller the dose, the stronger the medicine. But apparently us common folks are really the stupid ones, since there are “many” illustrious scientists who are homeopathy experts. So many that they got together to found an academic journal that no one has ever heard of.

Opponents of homeopathy claim that homeopathic medicines are “just plain water” with no medicinal properties. But increasing numbers of scientific findings are making it harder to maintain such as stance. One study has found that solutions prepared in the traditional homeopathic way — through repeated dilutions by mechanical shaking — have properties unlike plain water, with elements of the dissolved material. Another study suggests the solutions have an affect on living cells in vitro. Yet another study shows that solutions can be distinguished from each other, using the right equipment to determine their contents. And emerging research suggests that homeopathic solutions actually contain nanoparticles of the original dissolved material.

Once again, we are told that the science in favour of homeopathy is coming in, but we can’t evaluate any of it because Ms. Wehrstein failed to provide appropriate references for her claims. This is extremely odd, since she was able to link to other studies. I find it difficult to believe that this was an oversight.

It’s not quacks or junk scientists researching high dilutions. Dr. Luc Montagnier, Nobel laureate and co-discoverer of the human immunodeficiency virus, presented at a national American homeopathic conference last year, discussing his work on the ability of DNA in high dilutions to emit electromagnetic waves.

It is not unknown for smart people to believe in dumb things. In fact, there’s a depressingly long list of Nobel laureates in science and MD’s that believe in dumb things. With respect to Dr. Montagnier himself, he apparently hasn’t been able to convince any of his scientific colleagues that homeopathy has any merit, which is probably why he is currently presenting at pseudoscientific conferences. Dr. Montagnier may be a Nobel laureate but that does not make him a credible authority on homeopathy, in fact he can be a Nobel laureate, a quack and a junk scientist, all at the same time.

Conclusions

Karen Wehrstein’s best defence of homeopathy consisted of appealing to its popularity, selectively citing studies and meta-analyses that she surely knows have been heavily critiqued for their lack of merit, appealing to the authority of a nobel prize winner as if he’s infallible and finally playing the “keep an open mind” card – as if the rest of us are doing science wrong. As proponents of pseudoscientific medicine strive for legitimacy they ironically bring down upon themselves the kind of scrutiny that will, given enough time, result in the exposure of these practices as quackery. They can’t claim to be scientifically grounded and then insist that the standard by which everything else in science is judged is inappropriate for them. Nor can they continue to expect that regulators, patients and consumers should be content to simply wait until they can produce the required science to back their claims, while they carry on business as usual without regard to the consequences. Proof, or stop peddling water and sugar as if it’s medicine.

I can’t end this post without mentioning that apparently Ms. Wehrstein is under the impression that opponents of homeopathy are really attacking it because they are anti-woman. Really, she actually thinks this idea has merit. This is where homeopathy advocates are at, charging that criticism of homeopathy is motivated by misogyny. They are so arrogant they can’t even entertain the possibility that they are wrong.

“Randi, Ben Goldacre, Edward Ernst, Joe Schwarcz, Lorne Trottier, Iain Martell…” Wait, what was that last name? Not sure how I ended up in this rogue’s gallery, but I’m deeply honoured! And why did she leave out noted skeptic blogger – and raging misogynist – Dan Sousa?

Actually the notorious Swiss report is not really a report by he Swiss Government (they have explicitly stated this, why would Caulfield make this bogus claim?). The outcome of the Swiss review process was two reports, one, Shang et. al, being a review of evidence of effectiveness, the other, Bornhoft et. al., a review of the fiel itself.

The overall conclusion of the process was tha homeopathy is not effective. Reimbursement was withdrawn and only reinstated on a temporary basis after a political campaign in which Bornhoft et. al. Played a leading role. Th translated report is a rewrite for propaganda purposes after the event.

Anybody who says that the Swiss government supports homeopathy, or that this is a Swiss government report, is either woefully ill-informed or lying.

What happened to Free Will and allowing people to choose what is right from them?
Why are so many people invested in making it illegal when there is NO HARM TO YOU or OTHERS when I use Homeopathy to cure myself! Let me have my freedom of choice, stay out of my business and my life. For all that you care, I’ll just be one of those wackos that die off. I’m done trying to convince anybody of its effectiveness, I just want the opportunity to do what I believe is best for me- and I will continue to use Homeopathy for everything that ails me because it works… for me.

What you’re asking for is the freedom to choose among products and services that may be fraudulent. You’re arguing against consumer protection measures that exist for practically every other product or service you buy. Your call for freedom of choice is really a call to allow companies to conduct their business in a misleading way whether you realize this or not.

I would like to throw in my 2 cents here and mention that nobody here is trying to take away free will or your right to choose. What we are trying to do is:

1)Protect people from themselves and the quacks that attempt to prey on them. Everyone here who is interested in public health, works in public health, or would like to work in the field (me for example) care about other people. For example, despite the fact that I have never met you I would like for you to receive real medical care when you are sick and not be given (and charged for) sugar pills that have no effect. You suggest that we should leave you be and that you will “be one of those wackos that die off”. While it would perhaps be easier for us to allow that, it would be immoral and unethical. I feel that we are better people than that. So for this reason, even after you attack us for attempting to help you, we are still going to keep trying. No matter how often you yell at us or what profanities you may choose to hurl at us, we will keep trying to keep you safe and ensure that you get real treatment for Cancer, TB, Influenza, or any other illness that may befall you. Because we care about our fellow humans.

2) Science education worldwide seems to be a little lackluster in my opinion. The people posting here at SkepticNorth are trying to provide a valuable service in debunking false, pseudoscientific claims and trying to foster a basic level of understanding and scientific literacy that most people lack. If you can be made to believe in magic sugar pills then what’s to stop you from being fooled into thinking that magic beans are real? The point here is that being fed false or misleading information (of which there is plenty, coughcoughDr. Ozcoughcough)can result in you developing a false understanding of the universe and so making bad decisions. There seem to be few areas where this is as big of a problem as in the world of health care. SkepticNorth is one of many websites attempting to keep people from falling prey to bad information and developing a flawed interpretation of the world around them. Again this probably comes down to the fact that they care and want to keep people safe, healthy, and happy by protecting them from quacks, cranks, charlatans, and snake oil salesmen of all forms.

You should be free to choose your what healthcare treatments you receive but you should be provided with all of the details and the treatment you are spending your hard-earned money on should actually have at the very least a small chance of helping you. Homeopathy has no effect whatsoever beyond the placebo effect which may help with your subjective perception of the illness (ie. you “feel better”) but has absolutely no effect on the underlying problem (the cancer or bacterial infection isn’t being killed, your body isn’t actually forming antibodies to protect you against vaccine preventable illness, etc).
Again, no one is trying to take anything away, we are trying to make it so that you are given REAL options rather than being offered false cures and paying for plain water and lactose pills at inflated prices.

“Why are so many people invested in making it illegal when there is NO HARM TO YOU or OTHERS…”

Your assumption of no harm is not supported. We also have responsibility towards our children and others in the community. There are legal consequences for allowing a child to come to harm through neglect or denying effective treatment. Also, you might want to do some research about the dangers of decreased herd immunity, a likely consequence of large numbers of people choosing homeopathic vaccination over the real thing.

Aside from the potential for harm to others there is also a matter of wasting money or resources. You are certainly free to give as much of your income to quacks & charlatans as you like but when it comes to insurance policies or government funding I want maximum value for my premiums and/or tax dollars.

This is an excellent and eloquent rebuttal of all the standard nonsense we hear from the likes of Karen Wehrstein. Thank you.

What gets me is that increasingly the pro-homeopathy brigade have taken to insulting the opposition instead of talking science and evidence. If you don’t support homeopathy you are instantly accused of ‘scientism’, being uneducated, ignorant of the medical sciences (as if they aren’t!!), close minded, or just plain bigoted.

Laurie
Freedom to choose also requires knowledge about what you are choosing. We have consumer laws that protect the citizens against a whole range of unethical practices because most citizens do not have enough knowledge in a field to make proper decisions themselves.
Finanical advisors that take your money but don’t give you anything in return.
Mechanics that take your money but don’t fix your car.
Real MDs that make a mistake.

Yet, there are still a number of fraudulent practices that seem to be completely legal:
Taking your money and giving you a fancy bracelet that does none of the healing claims the seller says.
Sell you sugar pills or other products that do absolutely nothing.
Forecast your future but just make up a story that you want to hear.

The list goes on.

Why do you want protection against some liers that take your money and run but not form others? What is the difference between a financial advisor that takes your $5000 with lofty promises when he is putting it in an offshore bank acount for himself, and a person that takes 50 x $100 on a regular basis from you over a few years for treatments that do nothign?
Both are fraud and theft. Why do you want protection from one, but not the other?

Why does the government actually allow an advertisment with all sort of lofty claims as long as it is followed by a tiny disclaimer like “This product is not intended to diagnose, treat, cure, or prevent any disease.” Perhaps the advertisement should be preceeded by: “this product doestn’t do anything that the comercial claism. They are all lies to take your money”

Homeopathy works because the people who are good at it produce results. However, there are some people who try to practice homeopathy who have never trained with a well trained homeopath.

Homeopathy works at an energetic level. However, people want to scoff at this notion. But they’ll as readily admit that everything in the world is comprised of energy.

Because science has yet to catch up and find ways to figure out how it works doesn’t meant that it does not work. Similarly, we know that the ductus arteriosis by passes the lungs during fetal life and closes once the baby is delivered and the lungs take it’s first breath. Science can’t pinpoint why that happens. There’s no isolated gene. There are countless things medicine can’t explain, this doesn’t negate its viability.

Science is not the end all be all. In fact, most science these days in backed by financial incentive making it junk science. If this weren’t the case then we wouldn’t have so many reversals of “truth” every 5 or 10 years. It wasn’t too long ago that Ignes Semmelweiss was locked up for pursuing that not washing your hands prior to delivery of the baby was causing post partum hemorrhage. He was locked up. Where was science then?

Last, the only thing the left brained people can say is PLACEBO. This is the worst argument there is. Every drug has a placebo. But why is it then that naturopathic medicines have the highest placebo? Why is it that I know physicians personally who have not only improved patients with homeopathy, but cured them, long term?

1. Some answers (eg Swiss-German study) are in the links I have: Stephan Baumgartner and others have responded well to accusations of M. Shaw.
2. The government rejected the report of the House of Commons,
3. When Karen appointments on International Journal of High Dilution Research, actually you do not refute the comment of Karen.
4. When you mention “Nobel disease” is an ad hominem.

In the links I post can see that Randi Foundation and the Center for Inquiry organizmos you are interested in political control of science under certain interests of certain industries. They are not science nor the judge to decide who should and not scientific. The largest aberration is the fallacious argument “extraodinarias claims require extraordinary evidence.” You just apply the theme to your convenience and exhibit a double standard.

In the links I post can see that Randi Foundation and the Center for Inquiry organizmos you are interested in political control of science under certain interests of certain industries. They are not science nor the judge to decide who should and not scientific. The largest aberration is the fallacious argument “extraodinary claims requires extraordinary evidence.” You just apply the theme to your convenience and exhibit an double standard.

Once you and your ilk produce a valid, double-blind, controlled study with a decent sample-size in a peer-reviewed SCIENTIFIC journal, we will consider your input. In the meantime, you will be summarily ignored by the rational.

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Dianne holds a degree from the University of Guelph in criminal justice, public policy and social psychology. She became involved in the skeptical movement after becoming disillusioned with the addictions counselling field. Skeptical topics of interest include alternative medicine and it's regulation in Canada, pseudoscience and the law and skeptical activism. She also crochets extensively and enjoys bad film, usually at the same time. Follow me on twitter: @DianneSousa.
All views expressed by Dianne are her personal views alone, and do not represent the opinions of any current, former or future employers, or any organizations or associations that she may be affiliated with.